Extracorporeal Shockwave Lithotripsy: Initial Experience at Bahawalpur

Place of Study: American Kidney Stone Centre (AKSC), Bahawalpur, a private setup. Duration of Study: January 2005 to June 2007. Design of Study: Prospective, Observational. Material & Methods: A total of 250 patients were evaluated for ESWL results. The one session comprised of 1500-2500 shocks with intermittent fluoroscopy with X-Ray focusing. A period of 7 – 10 days was given between two sessions. The procedure was repeated till the clearance of stone no matter what was the number of sessions. The complications like pain, colic, hematuria were addressed adequately and immediately. The development of steinstrasse was initially observed and few required manipulation. The stone size is the only matter of concern in few patients especially lower pole stones. Results: The stone clearance was achieved in 89% of patients. Auxillary procedures were required in 10.8% before ESWL and 9.6% of patients after ESWL. Which include Endoscopic stenting and manipulation with uretero-renoscopy and intracorporeal lithotripsy. Prophylactic insertion of DJ stenting reduced complication rate and incidence of steinstrasse. Conclusion: ESWL can be safely recommended for patients of urolithiasis irrespective of age and stone size with promising results of stone clearance and patient acceptance.